Provider Demographics
NPI:1326181389
Name:KERN, BRUCE
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:KERN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 STONEHILL RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8517
Mailing Address - Country:US
Mailing Address - Phone:732-462-1917
Mailing Address - Fax:718-377-3062
Practice Address - Street 1:1600 PERRINEVILLE RD
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-4923
Practice Address - Country:US
Practice Address - Phone:609-409-9700
Practice Address - Fax:609-409-9797
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY425091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics